Indications,Causes of Delay and Failure of Decannulation after Tracheostomy in Treatment of Cervical Spinal Cord Injury
ZHAO Wei
LI Xiang
ZHANG Jun-wei
HONG Yi
Abstract：Objective To investigate the indications,delay and failure causes of decannulation after tracheostomy in treatment of cervical spinal cord injury. Methods Clinical data of 63 patients with cervical spinal cord injury after tracheosto-my was reviewed,and self-designed indications guidance for decannulation was used to choose the time of removing tubes. The delay and failure causes of decannulation were analyzed. Results The patients′oxygenation,expectoration and swallowing a-bilities were recoveried,the pulmonary infection was controlled,and there were no laryngeal edema by laryngoscope and bron-choscopes examinations and no obvious airway constriction in distal cannula. All above conditions were used as decannulation indications. Fifty four patients(85. 7%)underwent removal surgery of the tracheostomy tubes successfully within 3 months af-ter injury. The mean interval between incision of tracheal and decannulation was 43. 2 d. Seven patients(11%)had delayed decannulation,and the causes including repeated pulmonary infection in 3 patients,granulation tissue hyperplasia in distal tra-cheostomy tube in 2 patients,drinking bucking induced by recurrent laryngeal nerve injury after anterior cervical fusion in 1 patient and psychologic factor in 1 patient. Decannulation failure occurred in 2 patients and one received tracheostomy again and was discharged with the tracheostomy tubes,the other one died of acute respiratory failure. Conclusion Self-designed indication for decannulation may guide the time of removing the tracheostomy tubes safely for patients with cervical spinal cord injury after tracheostomy. Repeated pulmonary infection is the main cause of delayed and failed decannulation. Incidence rates of tracheal stenosis and tracheomalacia are low,but the complications may be life threatening,which should be given much more attention.
Keywords：Spinal cord injuryNeckTracheotomyAirway extubation
Publication Date：2014-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：3( 61-63 )